Exl Service

Reporting Analyst, Decision Analytics Services (Healthcare Payment Integrity Analyst)

US-NJ-Jersey City
ID
2017-4291
Type
Regular Full-Time
Job Code
DJOB

Overview

Healthcare Claims Analyst (Payment Integrity) 

 

EXL (NASDAQ:EXLS) is a leading operations management and analytics company that helps businesses enhance growth and profitability in the face of relentless competition and continuous disruption. Using our proprietary, award-winning Business EXLerator Framework™, which integrates analytics, automation, benchmarking, BPO, consulting, industry best practices and technology platforms, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 24,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), Latin America, Australia and South Africa.

 

EXL Analytics provides data-driven, action-oriented solutions to business problems through statistical data mining, cutting edge analytics techniques and a consultative approach. Leveraging proprietary methodology and best-of-breed technology, EXL Analytics takes an industry-specific approach to transform our clients’ decision making and embed analytics more deeply into their business processes. Our global footprint of nearly 2,000 data scientists and analysts assist client organizations with complex risk minimization methods, advanced marketing, pricing and CRM strategies, internal cost analysis, and cost and resource optimization within the organization.  EXL Analytics serves the insurance, healthcare, banking, capital markets, utilities, retail and e-commerce, travel, transportation and logistics industries.

 

Please visit www.exlservice.com for more information about EXL Analytics.

Responsibilities

  • Identify, validate and recover claims overpayment for US health insurance client.

  • Identifying overpayment opportunities by:

    • Reviewing claims processing policies and guidelines.
    • Reviewing provider contracts.
    • Analyzing historical overpayment trends.
    • Analyzing claims data to identify outliers.
  • Contribute toward team’s yearly target of overpayment identification.
  • Review and validate claims.
  • Assist team members and as and when required.
  • Maintain and track overpayment projects in organized and timely manner.
  • Adhere to all client and company policies without exceptions.

Qualifications

  • Minimum 2 years of claims processing experience on Medicaid claims for state of NJ (Mandatory).
  • Minimum 2 years of experience on Facet’s claim systems (Mandatory)
  • Expertise in US Health Insurance Claims Processing and adjustments (Mandatory)
  • Bachelor's degree in science, medical or humanities (arts, economics or social science)
  • Good communication skill for client interaction experience
  • Good basic mathematics, reasoning, and interpretation skills
  • Working knowledge of MS Excel/Access/PowerPoint for project delivery
  • Basic understanding of SQL and VBA (preferred)
  • Experience in reporting and data analysis (preferred)

What we offer: 

  • EXL Analytics offers an exciting, fast paced and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. From your very first day, you get an opportunity to work closely with highly experienced, world class analytics consultants.
  • You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth
  • Analytics requires different skill sets at different levels within the organization. At EXL Analytics, we invest heavily in training you in all aspects of analytics as well as in leading analytical tools and techniques.
  • We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
  • Sky is the limit for our team members. The unique experiences gathered at EXL Analytics sets the stage for further growth and development in our company and beyond.

"EOE/Minorities/Females/Vets/Disabilities"

EEO Statement

EEO/Minorities/Females/Vets/Disabilities

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